Abstract
Type 2 Diabetes Mellitus (T2DM) is a health problem of paramount proportions and is associated with significant morbidity and mortality. Our study aims to review data published on the effects of different types of bariatric surgeries on T2DM remission, compared to lifestyle and medical intervention (LMI) exclusively, along with a comprehensive finding of numerous preoperative factors that lead to remission. We used PubMed, PubMed Central (PMC), and MEDLINE to search for literature. Our criteria included peer-reviewed, English language articles published in 2010 and onwards, consisting of adults with T2DM and a body mass index (BMI) of >30 kg/m2 as the population of interest. Twenty-four articles with 5,411 patients were selected for this systematic review, which included nine randomized controlled trials (RCTs) and 15 observational studies. The primary endpoint was T2DM remission. Based on the review, bariatric surgery is superior to LMI in inducing remission in T2DM, especially when employing the Roux-en-Y Gastric Bypass (RYGB) technique. Lower age of onset and shorter duration of T2DM, along with a high BMI are some of the factors that can lead to greater remission rates. Further research in RCTs is needed by incorporating double/triple-blind protocols, a standard definition of T2DM remission, long follow-up periods to evaluate for relapses in remission and any side effects, with a focus on inflammatory markers (eg, osteopontin), scoring systems (eg, DiaRem), and benefits of One-Anastomosis Gastric Bypass (OAGB) over other modalities, to advance our understanding of T2DM remission.
Highlights
BackgroundObesity is one of the leading global causes of preventable deaths and has rapidly become a health issue of epidemic proportions, impacting people of all ages, from children and adolescents to adults [1,2,3]
Our study aims to review data published on the effects of different types of bariatric surgeries on Type 2 Diabetes Mellitus (T2DM) remission, compared to lifestyle and medical intervention (LMI) exclusively, along with a comprehensive finding of numerous preoperative factors that lead to remission
Bariatric surgery is superior to LMI in inducing remission in T2DM, especially when employing the Roux-en-Y Gastric Bypass (RYGB) technique
Summary
BackgroundObesity is one of the leading global causes of preventable deaths and has rapidly become a health issue of epidemic proportions, impacting people of all ages, from children and adolescents to adults [1,2,3]. Ninety percent of all T2DM patients have excess body weight, which is associated with an increased likelihood of developing complications such as hypertension and cardiovascular disease [4]. The risk of developing T2DM is directly related to an individual's body mass index (BMI). This risk can range from 2%, for BMI 25 to 29.9 kg/m2, to 13%, for BMI >35 kg/m2 [7]. The desired goals for the treatment are hemoglobin A1c (HbA1c)
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